Individual
CHARLES S GERY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1802 BRAEBURN DR, SUITE 1310, SALEM, VA 24153-7357
(540) 776-2020
(540) 776-2017
Mailing address
PO BOX 277730, ATLANTA, GA 30384-7730
(615) 373-7600
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0110840469
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962484915
—
VA
01
—
P00413631
MEDICARE RR
—
01
—
P00453914
RAILROAD MEDICARE
VA
Enumeration date
11/16/2005
Last updated
03/20/2009
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